1. Field of the Invention
This invention relates to a method and apparatus for modifying a soft tissue structure underlying a skin surface, and more particularly to a method and apparatus which applies a mechanical force and electromagnetic energy to the soft tissue structure.
2. Description of Related Art
The correction of a deformity or the esthetic enhancement of a soft tissue structure is determined by the balance of the skin envelope as the container and soft tissue volume as the contents of the container. An appropriate balance between these two components is essential in achieving a successful outcome. Most plastic surgery procedures are based upon the resection or addition of a soft tissue filler with a concomitant modification of the skin envelope. For example, a breast that has three dimensional symmetry with the opposite breast must take into account both the volume of the soft tissue and the surface area of the breast envelope that is required as a container of the tissue. Breast reconstruction after mastectomy typically involves the insertion of a soft tissue replacement for the removed breast tissue. Either an implant or a tissue flap from the patient is used as a soft tissue replacement. Expansion of the breast skin envelope is also required and is achieved with a medical device called a breast expander. While most reconstructive procedures usually involve the addition of a soft tissue filler with the expansion of the skin envelope, many esthetic procedures involve the reduction of the soft tissue contents with or without a reduction in the skin envelope. Reduction in the volume of the soft tissue contents without a concomitant reduction in the skin envelope may lead to a relative excess of the skin envelope. The relative excess will be visualized as loose skin or elastosis. An example of esthetic enhancement is a procedure called breast reduction. This is performed in women who require reduction in the size of their breasts to alleviate shoulder, neck and back symptoms. Breast tissue is resected to reduce volume but also requires a reduction in the breast skin envelope with extensive surgical incisions. Without reduction of the skin envelope of the breast, severe ptosis (droopiness) of the breast will occur.
Another example is liposuction which may aggravate elastosis because the soft tissue content is reduced without reduction in the surface area of the skin envelope. The degree of esthetic contour reduction is limited by the preexisting looseness of the skin envelope. Typically, liposuction involves the removal of subcutaneous fat through a suction cannula inserted through the skin surface. Excess suctioning of fat will aggravate any preexisting elastosis. Any other modality that reduces subcutaneous fat through dieting or ablation of fat cells is likely to aggravate a preexisting elastosis if a concomitant reduction of the skin envelope does not occur. This is especially true in the hip and thigh area where a condition called xe2x80x9ccellulitexe2x80x9d is due to a preexisting looseness of skin. Many patients have a more severe looseness of skin in the hip and thigh area that would be aggravated by any fat removal. Skin tightening procedures that involve large surgical incisions result in severe scarring to the thigh and hip area that are a poor trade off to any esthetic contour reduction.
There is a need for a method and apparatus to achieve skin tightening without major surgical intervention. There is a further need for a method and apparatus to achieve skin tightening by the controlled remodeling of collagen in the skin and underlying fibrous partitions of the subcutaneous fat. Still a further need exists to tighten a skin envelop with minimal skin or underlying subcutaneous tissue cell necrosis. Yet another need exists to provide a method and apparatus for the controlled remodeling of collagen in tandem with subcutaneous fat ablation in which a net tightening of the skin envelope occurs with an esthetic contour reduction.
Accordingly, an object of the invention is to provide a method and apparatus to tighten skin.
Another object of the invention is to provide a method and apparatus for creating a reverse thermal gradient through a skin surface.
Yet another object of the invention is to provide a method and apparatus for creating a reverse impedance gradient from the skin surface to underlying tissue.
Still another object of the invention is to provide a method and apparatus for hydrating the skin.
Another object of the invention is to provide a method and apparatus for creating a reverse thermal gradient from the skin to underlying tissue, with the creation of an ablation in the underlying tissue.
Yet another object of the invention is to provide a method and apparatus that creates an intracellular suppression of a tissue site underlying the skin surface.
A further object of the invention is to provide a method and apparatus that modifies a physiological function of a tissue site underlying the skin.
These and other objects of the invention are achieved in an apparatus for modifying a skin surface or a soft tissue structure underlying a skin surface. The apparatus includes a skin surface conforming member and a hydration delivery device coupled to the conforming member. The hydration delivery device delivers a hydration agent to the skin surface. An energy delivery device is coupled to the conforming member and provides a controlled delivery of energy to the skin surface.
In one embodiment of the present invention, an apparatus for modifying a skin surface or a soft tissue structure underlying a skin surface includes a template positionable adjacent to the skin surface to apply a mechanical force through the skin surface. A hydration delivery device is coupled to the conforming member and delivers a hydration agent to the skin surface. An energy delivery device is coupled to the conforming template and provides a controlled delivery of energy to the skin surface.
In another embodiment, a method produces a tightening of a surface of a skin with an underlying collagen containing tissue. An energy delivery device is provided with an energy delivery surface coupled to a hydration delivery member.
The energy delivery surface on a surface of the skin and the surface of the skin is hydrated. A reverse thermal is created through the surface of the skin to heat an underlying collagen containing tissue. The temperature of the surface of the skin is lower than a temperature of the underlying collagen containing tissue and at least a portion of the surface of the skin is tightened.
In another embodiment of the invention is a method that tightens a surface of the skin. An energy delivery device is provided with an energy delivery surface coupled to a hydration delivery member. The energy delivery surface is positioned on a surface of the skin and the skin surface is hydrated. A reverse impedance gradient is formed through the skin surface to an underlying collagen containing tissue. An ECF of the surface layers of the skin, stratum comeum, epidermis, and superficial dermis of the skin, is increased and ECF of the underlying collagen containing tissue is decreased in comparison to the pre-hydration state. At least a portion of the skin surface is tightened.